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. 2016 Oct;29(5):384-9.
doi: 10.1177/1971400916665385. Epub 2016 Aug 16.

Is size an essential criterion to define tumefactive plaque? MR features and clinical correlation in multiple sclerosis

Lucia Patriarca  1 , Silvia Torlone  1 , Fabiana Ferrari  1 , Caterina Di Carmine  2 , Rocco Totaro  2 , Ernesto di Cesare  1 , Alessandra Splendiani  3
Affiliations

Is size an essential criterion to define tumefactive plaque? MR features and clinical correlation in multiple sclerosis

Lucia Patriarca et al. Neuroradiol J. 2016 Oct.

Abstract

Tumefactive multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. It has recently been described as a rare subtype of multiple sclerosis (MS) characterised by the appearance of solitary or multiple space-occupying lesions associated with imaging characteristics mimicking neoplasm. Atypical features include plaque size >2 cm with mass effect, oedema, and/or ring enhancement on magnetic resonance (MR) images.This study is a retrospective review designed to evaluate the prevalence of tumefactive plaques in a selected population of 440 MS patients referred to our MS centre in Southern Italy between 2005 and 2014. We analysed the radiographic features of lesions ranging in size from 0.5 to 2 cm to establish whether smaller plaques with MR characteristics similar to tumefactive plaques present different symptoms, disease evolution and prognosis. We also aimed to ascertain if MR features suggestive of biological aggressiveness could be useful prognostic criteria for a correct diagnosis of the disease and subsequent treatment. Our data suggest that lesions 0.5-2 cm and >2 cm have similar MR features and clinical evolution.

Keywords: Multiple sclerosis; magnetic resonance imaging; tumefactive demyelinating lesions.

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Figures

Figure 1.
Figure 1.
A 42-year-old woman. Axial T2-weighted image demonstrates tumefactive plaque located in the temporal region. The lesion is >2 cm and with well-defined margins, mild mass effect, mild oedema and a classic T2-weighted hypointense rim.
Figure 2.
Figure 2.
A 35-year-old woman. Axial T2-weighted image demonstrates multiple tumefactive plaques. The lesions are >2 cm with well-defined margins, mild mass effect, mild oedema and a classic T2-weighted hypointense rim.
Figure 3.
Figure 3.
A 21-year-old man. Axial T1-weighted images demonstrate hypointensity of a tumefactive plaque located in the parietal region.
Figure 4.
Figure 4.
A 44-year-old woman. Sagittal T1-weighted image after contrast administration demonstrates a tumefactive plaque located in the temporal region. The lesion is > 2 cm with well-defined margins and ring enhancement.
Figure 5.
Figure 5.
A 20-year-old woman. Axial T1-weighted image after contrast administration demonstrates a tumefactive plaque located in the periventricular region. The lesion is < 2 cm with well-defined margins and concentric enhancement.
Figure 6.
Figure 6.
Location of plaques in Group A multiple sclerosis patients.
See this image and copyright information in PMC

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